1841686193 NPI number — MS. KATHRYN VARGO GRAY APRN BC FNP

Table of content: MS. KATHRYN VARGO GRAY APRN BC FNP (NPI 1841686193)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841686193 NPI number — MS. KATHRYN VARGO GRAY APRN BC FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRAY
Provider First Name:
KATHRYN
Provider Middle Name:
VARGO
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN BC FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VARGO
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
DOLORES
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841686193
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1730 OLD COLLARD VALLEY RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKMART
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30153
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-307-9441
Provider Business Mailing Address Fax Number:
770-886-0404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1730 OLD COLLARD VALLEY RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKMART
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-307-9441
Provider Business Practice Location Address Fax Number:
678-685-4683
Provider Enumeration Date:
04/14/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364S00000X , with the licence number:  RN129146 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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